With cardiovascular diseases being one of the major causes of premature deaths in the UK, cardio monitoring technology is critical, now more than ever, to identifying underlying heart issues and has the potential to transform patient care across the country. We learn more from Jay (David) Wright, Consultant Cardiologist, Liverpool Heart and Chest Hospital, iRhythm Advisor.
HOW WEARABLE TECH CAN TRANSFORM CARDIOLOGY
Currently in the UK, over seven million people are living with heart and circulatory diseases.
Of this number, two million are living with arrhythmias and around 1.5 million with atrial fibrillation (AF), conditions that too often go undetected until they trigger avoidable harm, with AF increasing the risk of stroke five-fold.
As patients live longer after infections and cancers, we are seeing more rhythm problems, also caused by the well‑known impacts of obesity, physical inactivity, and alcohol. Add the uncertain long‑term effects of widespread vaping and post‑viral syndromes, and the pressures on cardiology are unmistakable.
For the first time in half a century, deaths from cardiovascular disease (CVD) in the UK are rising. The number of people being admitted to hospital following a stroke has risen by 28 percent in the last 20 years, while it’s estimated that around 100,000 hospital admissions each year are due to heart attacks.
In clinics across the country, the question is no longer whether we need to change how we diagnose heart rhythm disorders, but how quickly we can do it.
OUTGROWING YESTERDAY’S MONITORING
For years, the tools at our disposal have lagged behind the needs of patients and failed to diagnose arrhythmias at a stage when they can be managed to prevent strokes and heart attacks.
The traditional approach has asked patients to accept compromises, all the while missing too many clinically important diagnoses. Patients have to tolerate cumbersome Holter monitors with wires and a belt‑worn box, usually for 24 to 48 hours, which are uncomfortable, restrict daily life, and lack the sensitivity to catch sporadic symptoms.
Implantable loop recorders, an alternative to Holter monitors, address sensitivity but at a high cost and with an invasive procedure that then requires removal – a more time-consuming option for an already stretched NHS.
Advanced monitoring tools, such as wearable patch technology, are already offering a more accurate diagnostic yield and greater patient comfort and operational efficiency, enabling continuous ECG in a form patients barely notice.
This ongoing monitoring is crucial for earlier detection; many arrhythmias are intermittent and simply won’t appear in a 24-to-48-hour window. More advanced care delivers a markedly higher diagnostic yield, shortening the time to diagnosis and reducing unnecessary hospital visits – all while letting people work, exercise, and go about their daily life as normal.
As we move past outdated equipment and diagnostic practices, wearable technology can help close gaps in cardiovascular disease diagnosis.
TACKLING INEQUALITIES IN CVD DIAGNOSIS
Cardiovascular disease is not evenly distributed.
Firstly, socioeconomic status strongly influences health outcomes, with some regions noting higher death rates from CVD.
Secondly, gender disparities result in an underdiagnosis of women who are too often misattributed, leading to delays in diagnosis.
Lastly, ethnic disparities persist in both risk and mortality. In the UK, South Asian communities experience higher rates of type 2 diabetes which can contribute to earlier and more aggressive coronary disease, while Black African and Caribbean communities have higher rates of hypertension and stroke.
All of these issues are compounded by a lack of time to visit hospitals, language barriers, and a lower representation in research datasets. If we solely rely only on in‑hospital diagnostics and outdated equipment, we risk reinforcing these gaps.
Wearable technology allows for more flexibility in diagnosis, which can help to tackle these inequalities.
Patch technology, for example, can be posted directly to patients with instructions for self‑application and removal. This simple operational shift expands access to high‑quality diagnostics for people who struggle to attend hospital appointments, whether because of work, caring responsibilities, or distance.
It also reduces unnecessary trips to the hospital and strain on the NHS; rather than having to slot in multiple hospital visits for the fitting and removal of traditional devices, patients can receive and send back their monitors in the post.
This aligns closely with the NHS 10 Year Health Plan for England; shifting diagnostics out of the hospital and into the community, enabling earlier detection and referral of the right patients, not just the most persistent ones.
FROM PILOTS TO IMPACT
The UK is rightly cautious with public money, but adoption pathways can be painfully slow. Even when evidence is compelling, the roll out of new technologies can stall while funding codes are agreed and pathways redesigned. The result is a patchwork of pilots and postcode lotteries.
Current pilots include the role of artificial intelligence (AI)-powered analysis in supporting clinicians with early diagnosis of CVD. Once traditional monitoring devices are removed, analysing the data can be time-consuming, creating backlogs in diagnoses.
However, advanced algorithms can analyse prolonged ECG data and generate clear, structured reports. This streamlined workflow lightens the load across the system. It also means physiologists and nurses spend less time on manual annotation, consultants see more of the right patients with the right information, and emergency departments face fewer non‑specific palpitations that could have been addressed earlier in primary care.
To bring this into more hospitals across the UK we need a faster lane from pilots to wider use. This means having clear national commissioning guidance for prolonged ambulatory ECG monitoring, with aligned reimbursement so integrated care boards (ICBs) can scale confidently.
It also requires, amongst other things, a prioritisation of prolonged monitoring for cohorts with known underdiagnosis: women with atypical symptoms, older adults with falls or syncope, and high‑risk ethnic communities.
Technology in the health sector can be a means to earlier answers, fairer access, and improved patient care.
The test of success is simple: is this tech diagnosing the right condition, sooner, and with less friction for patients and staff? With wearable patches, the answer is, increasingly, yes. The challenge now is to move beyond pilots and make that ‘yes’ the experience of patients across the UK, not just those lucky enough to live near an early‑adopting service.
If we do this, we will detect more AF before the stroke, explain more palpitations without a hospital visit, and keep more people living the lives they want. In a health system under pressure, that is the kind of innovation we cannot afford to delay.
